scholarly journals Influence of Antibiotic-Loaded Acrylic Bone Cement Composition on Drug Release Behavior and Mechanism

Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2240
Author(s):  
I-Cheng Chen ◽  
Chen-Ying Su ◽  
Wei-Han Nien ◽  
Tzu-Tien Huang ◽  
Chang-Hung Huang ◽  
...  
Keyword(s):  
Infection Control ◽  
Bone Cement ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Joint Infection ◽  
Acrylic Bone Cement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Antibiotic Release

Periprosthetic joint infection (PJI) is a devastating complication after total joint replacement with considerable morbidity and large economic burdens. Antibiotic-Loaded Bone Cement (ALBC) has been developed as a valuable tool for local administration and is becoming one of the most effective methods for the prevention and treatment of orthopedic infections. Controlling antibiotic release from ALBC is critical to achieve effective infection control, however, the antibiotic elution rates are generally low, and the mechanisms are poorly understood. Thus, the present study aims to investigate the effects of the basic acrylic bone cement components, including liquid/powder (monomer-to-polymer) ratios, radiopacifier, initiator, and doses of antibiotics on the porosity, antibiotic elution rates and mechanical properties of polymethylmethacrylate (PMMA) based ALBC. The obtained results from the in vitro studies suggested that a reduction in the liquid/powder ratio and an increase in the radiopacifier ratio and gentamicin doses led to increased porosity and release of antibiotic, while the initiator ratio exerted no effect on elution rates. In conclusion, we hope that by varying the composition of ALBC, we could considerably enhance the antibiotic elution rates by increasing porosity, while maintaining an adequate mechanical strength of the bone cements. This finding might provide insights into controlling antibiotic release from ALBC to achieve effective infection control after total joint replacement surgery.

scholarly journals Progress in Prevention, Diagnosis, and Treatment of Periprosthetic Joint Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kai Wang ◽  
Wei Li ◽  
Huayu Liu ◽  
Yang Yang ◽  
Lingyun Lv
Keyword(s):  
Joint Replacement ◽  
Periprosthetic Joint Infection ◽  
Total Joint Replacement ◽  
Joint Infection ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
High Morbidity ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Increased Risk

Periprosthetic joint infection (PJI) after joint replacement surgery is a severe complication associated with high morbidity and increased treatment costs. More than 25% of joint implant failures are attributed to PJI. PJI diagnosis and treatment methods have substantially improved in recent years. However, the prevalence of PJI remains high, primarily due to the increased prevalences of obesity, diabetes, and other underlying conditions. Moreover, increasing elderly prefers to total joint replacement surgery. However, due to frailty and comorbidities, most are at increased risk of infectious arthritis and artificial joint infection (PJI). Therefore, PJI management for the elderly requires multilevel and multiangle intervention. In this review, we summarize the risk factors and diagnostic methods currently available for PJI and discuss the current PJI prevention and treatment interventions, especially the management in older adults.

scholarly journals COVID-19 (SARS-CoV-2) lymphocyte responses are associated with inflammatory biomarkers in total joint replacement surgery candidates pre-operatively

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marco S. Caicedo ◽  
Vianey Flores ◽  
Alicia Padilla ◽  
Samelko Lauryn ◽  
Joshua J. Jacobs ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Cross Reactivity ◽  
Inflammatory Biomarkers ◽  
Nucleocapsid Proteins ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Operative Planning ◽  
Lymphocyte Responses ◽  
Reactive Lymphocytes

Abstract Background Recent studies indicate that, in addition to antibody production, lymphocyte responses to SARS-CoV-2 may play an important role in protective immunity to COVID-19 and a percentage of the general population may exhibit lymphocyte memory due to unknown/asymptomatic exposure to SARS-CoV-2 or cross-reactivity to other more common coronaviruses pre-vaccination. Total joint replacement (TJR) candidates returning to elective surgeries (median age 68 years) may exhibit similar lymphocyte and/or antibody protection to COVID-19 prior to vaccination Methods In this retrospective study, we analyzed antibody titters, lymphocyte memory, and inflammatory biomarkers specific for the Spike and Nucleocapsid proteins of the SARS-CoV-2 virus in a cohort of n=73 returning TJR candidates (knees and/or hips) pre-operatively. Results Peripheral blood serum of TJR candidate patients exhibited a positivity rate of 18.4% and 4% for IgG antibodies specific for SARS-CoV-2 nucleocapsid and spike proteins, respectively. 13.5% of TJR candidates exhibited positive lymphocyte reactivity (SI > 2) to the SARS-CoV-2 nucleocapsid protein and 38% to the spike protein. SARS-CoV-2 reactive lymphocytes exhibited a higher production of inflammatory biomarkers (i.e., IL-1β, IL-6, TNFα, and IL-1RA) compared to non-reactive lymphocytes. Conclusions A percentage of TJR candidates returning for elective surgeries exhibit pre-vaccination positive SARS-CoV-2 antibodies and T cell memory responses with associated pro-inflammatory biomarkers. This is an important parameter for understanding immunity, risk profiles, and may aid pre-operative planning. Trial registration Retrospectively registered.

Quantifying function before and after total joint replacement surgery in patients with hip osteoarthritis

2015 ◽  
Vol 42 ◽  
pp. S32
Author(s):  
J.E. Naili ◽  
A.C. Esbjörnsson ◽  
M.D. Iversen ◽  
M.H. Schwartz ◽  
C. Häger ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Hip Osteoarthritis ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Before And After

Development of operator independent bone cement vacuum mixing system for joint replacement surgery

2006 ◽  
Vol 35 (8) ◽  
pp. 317-323 ◽  
Author(s):  
N. Dunne ◽  
Y. Xu ◽  
C. Daly ◽  
J. Makem ◽  
G. Walker ◽  
...  
Keyword(s):  
Bone Cement ◽  
Joint Replacement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Vacuum Mixing
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